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The titular character of the movie Rain Man is an autistic savant, and the movie centers on his relationship with his non-autistic but selfish brother. Particularly memorable scenes involve the brothers' travels; they initially lacked empathy and understanding toward each other, but they learn and expand their relationship as they spend time together. In this manuscript, I provide examples of truly amazing visual and mathematic abilities among some high-functioning autistic savants, and I introduce several hypotheses regarding the mechanisms that may underlie autism spectrum disorder, from a neuroscience perspective. The significance of these hypotheses and the current research directions are also discussed.

In this review, the brain substrate underlying outstanding artistic ability was discussed from the viewpoint of "neuroaesthetics" and savant syndrome. Beauty is a multifaceted concept and is related to other multiple cognitive or affective functions, for which the medial orbitofrontal cortex is the hub and core region of the brain. The savant syndrome is known for outstanding and talented abilities including art despite otherwise severe brain dysfunction. The savant syndrome is usually classified into the essential savant observed in autism spectrum disorders and acquired savant often observed in dementia/degenerative diseases or focal brain damage. The paradoxical functional facilitation hypothesis may account for the savant syndrome, in which focal brain dysfunction may paradoxically enhance/facilitate functions in the other areas of the brain. This implication is important and useful in understanding the recovery/treatment of neuropsychiatric conditions.

Oshikuramanju is a simple Japanese, competitive game and we adapted the name to describe "competition" between different brain functions related to Savant syndrome. We also show that Savant-like ability exists in animals other than humans and describe three types of Savant syndrome: autistic, acquired, and transcranial magnetic stimulation.

Objectives: In this study, we attempted to evaluate the ability of self-care among elderly patients with diabetes mellitus and its association with the health locus of control and social support., Methods: Participants comprised 173 community-dwelling outpatients with type-2 diabetes, aged over 50 years (M±SD: 67±9 years). Data on self-care ability, health locus of control, and social support were collected using self-administered questionnaires and by structured interviews, and were analyzed by structural equation modeling to verify the interrelationships between variables., Results: Elderly patients (≥65 years, n=109) exhibited significantly higher scores on the self-care ability scale than middle-aged patients (<65 years, n=67). Among elderly patients, those with high scores of self-care ability tended to attribute their health to external agents such as their family or supernatural phenomena rather than their own actions. On the basis of structural equation modeling, the belief that a participant's health was dependent on family members and the family members' actual assistance were found to be significant factors for providing effective support to elderly patients' health-care behaviors. Furthermore, close friendships contributed to the improvement of health-care ability among elderly patients, whereas the spouse's aid was crucial for middle-aged patients., Conclusions: These results suggest that the health locus of control and social support are important considerations when providing health guidance or counseling to improve the self-care ability among elderly patients with diabetes mellitus.

Objective: We aimed to examine the effects of reading difficulties on scholastic self-evaluation and mental health in elementary school students., Methods: Following guidelines for diagnosing reading disorders in elementary school students, we administered reading test batteries consisting of single sounds, single words, and single sentences to 41 fifth-grade elementary school students in Japan. The students' levels of scholastic self-evaluation, self-esteem, and depressive symptoms were assessed using self-rating questionnaires., Results: By evaluating students' reading speed and the number of reading errors they made, we found that six students (14.6%) had reading difficulties (RD group) as per the guidelines for diagnosing reading disorders. The scholastic self-evaluation scores of this RD group were significantly lower than that of the non-RD group. No significant differences were found between the groups on self-esteem or depressive symptoms scores, which we considered to be indicators of mental health, Speed in reading single sounds and single words, and the number of reading errors in reading single sounds had significant negative correlations with scholastic self-evaluation scores., Conclusion: We found that reading difficulties might result in decreased scholastic self-evaluation in elementary school students; however, reading difficulties did not directly influence self-esteem or depression.

The increase in the number of universities in Japan in spite of a decrease in the number of enrollees is causing a decline in the academic ability of undergraduates. The diversification of selection methods also contributes to the deterioration of the situation. Some students and teachers in high schools still hold the prejudice that only chemistry is important in the entrance examination for schools of pharmacy. To study pharmaceutical sciences, biology is as important as chemistry, and the number of students who have difficulty in obtaining biology course credits is increasing. Logical thinking based on the established knowledge in basic sciences is necessary for a successful clinical clerkship. However, students are inexperienced in logical thinking using the knowledge learned in their classes. This is why practice is needed during the basic pharmaceutical course. We made it compulsory for all second- and third-year students to take practical courses in physics, chemistry, and biology. In addition, a program in which a tutor conducted individual practice for students was carried out. A change in students' sense of purpose in learning was achieved by changing the method and environment of learning.

It is well known that the cases with savant syndrome, demonstrate outstanding mental capability despite coexisting severe mental disabilities. In many cases, savant skills are characterized by its domain-specificity, enhanced memory capability, and excessive focus on low-level perceptual processing. In addition, impaired integrative cognitive processing such as social cognition or executive function, restricted interest, and compulsive repetition of the same act are observed in savant individuals. All these are significantly relevant to the behavioral characteristics observed in individuals with autistic spectrum disorders (ASD). A neurocognitive model of savant syndrome should explain these cognitive features and the juxtaposition of outstanding talents with cognitive disabilities. In recent neuropsychological studies, Miller (1998) reported clinical cases of "acquired savant," i.e., patients who improved or newly acquired an artistic savant-like skill in the early stage of frontotemporal dementia (FTD). Although the relationship between an autistic savant and acquired savant remains to be elucidated, the advent of neuroimaging study of ASD and the clarification of FTD patients with savant-like skills may clarify the shared neural mechanisms of both types of talent. In this review, we classified current cognitive models of savant syndrome into the following 3 categories. (1) A hypermnesic model that suggests that savant skills develop from existing or dormant cognitive functions such as memory. However, recent findings obtained through neuropsychological examinations imply that savant individuals solve problems using a strategy that is fairly different from a non-autistic one. (2) A paradoxical functional facilitation model (Kapur, 1996) that offers possible explanations about how pathological states in the brain lead to development of prodigious skills. This model emphasizes the role of reciprocal inhibitory interaction among adjacent or distant cortical regions, especially that of the prefrontal cortex and the posterior regions of the brain. (3) Autistic models, including those based on weak central coherence theory (Frith, 1989), that focus on how savant skills emerge from an autistic brain. Based on recent neuroimaging studies of ASD, Just et al. (2004) suggested the underconnectivity theory, which emphasizes the disruption of long-range connectivity and the relative intact or even more enhanced local connectivity in the autistic brain. All the models listed above have certain advantages and shortcomings. At the end of this review, we propose another integrative model of savant syndrome. In this model, we predict an altered balance of local/global connectivity patterns that contribute to an altered functional segregation/integration ratio. In particular, we emphasize the crucial role played by the disruption of global connectivity in a parallel distributed cortical network, which might result in impairment in integrated cognitive processing, such as impairment in executive function and social cognition. On the other hand, the reduced inter-regional collaboration could lead to a disinhibitory enhancement of neural activity and connectivity in local cortical regions. In addition, enhanced connectivity in the local brain regions is partly due to the abnormal organization of the cortical network as a result of developmental and pathological states. This enhanced local connectivity results in the specialization and facilitation of low-level cognitive processing. The disruption of connectivity between the prefrontal cortex and other regions is considered to be a particularly important factor because the prefrontal region shows the most influential inhibitory control on other cortical areas. We propose that these neural mechanisms as the underlying causes for the emergence of savant ability in ASD and FTD patients.

The purpose of this study was to develop the Japanese Defensive Pessimism Inventory (JDPI), which measures defensive pessimism in an academic achievement situation for Japanese undergraduate students and differentiates between those who are realistically pessimistic and those who are defensively pessimistic. In Study 1,695 undergraduates completed the JDPI. A factor analysis revealed that the 24 items of the JDPI comprised four factors: Pessimism, Past experience, Positive reflectivity, and Effort. In Study 2, 618 undergraduates completed the JDPI, the Test Coping Strategy Scale, and the State-Trait Anxiety Inventory. The JDPI had high internal consistency and test-retest reliability. Defensive pessimists and strategic optimists had higher scores on the active coping strategy and lower scores on the avoidant-thinking coping strategy than did realistic pessimists. Furthermore, defensive pessimists and realistic pessimists had higher scores on the state anxiety and lower scores on the optimistic-thinking coping strategy than did strategic optimists. The results indicate that the JDPI had high concurrent validity.

We talked about the evaluation of students' writing; this is thought to be difficult for teachers. We have a class "history of medicine" for freshmen in the second semester of the medical course. Students give lecture by themselves on famous historical persons in medicine such as Hippocrates, Vesalius, Pasteur and Sackett, referring to their historical significance in present medicine. As the final work of the subject they write report on "clinical medicine or medical researches 20 years in future and myself". We talked generally about educational evaluation in various aspects, concerning the methods for writing. We discussed mainly on two themes--ability to write and originality in thinking. We give a larger point to the originality, which correlates to ability to write, though we feel difficult in evaluating students' originality only by reading their reports. We also emphasize the importance of active interaction between students and teachers, and to evaluate educational activities of teachers in Japanese universities.

Selection of others for comparison influences the outcome of self-assessment. The present study attempted to examine the effect of expectation for self-enhancement on strategic selection of comparisons. A questionnaire study was conducted with 169 undergraduates, who responded to four sets of questions. First, they listed ten abilities each for three areas that desired to acquire in high-level, in average-level, and undesired to acquire. Then, they evaluated themselves in comparison with others on the thirty abilities, and indicated whom they chose as comparisons. Finally, perceived probabilities were assessed of acquiring each ability. Results showed that selection of superior others was more when evaluated abilities were desired to acquire in high-level and perceived probability high than otherwise. This suggested that comparison with superior others was made if expectation for self-enhancement was high. The expectation therefore affects the likelihood of self-assessment behavior, and self-assessment is a necessary component of future self-enhancement.

The purpose of this study is to investigate the relationships of professional autonomy in nursing with demographic and psychological variables. The measure of professional autonomy in nursing is constructed by five factors, "Cognition", "Performance", "Concrete judgement", "Abstract judgment" and "Independent judgment", respectively and interpreted to represent the professional work abilities of nursing. Age, years of experience of nursing, arrangement of work place in the hospital, position level and educational background of nursing are selected as demographic variables. Psychological variables used in this study were intention to continue at work as a nurse, work satisfaction and motivation, self confidence and self evaluated aptitude toward nursing. Three-hundred and seventy professional nurses in the public hospital were administered a questionnaire including the five-point scale for professional autonomy in nursing and several demographic and psychological variables. The main results were as follows: (1) Each of the sub-scale scores of professional autonomy in nursing had significant and positive correlations with age, years of experience, work satisfaction and motivation, self confidence and aptitude toward nursing. (2) Nurses worked at the intensive care unit and operation room were significantly higher scores of professional autonomy in nursing than the nurses at the ward and the outpatient clinic. (3) Professional autonomy in nursing was totally increasing with the increase of nurse's position and years of experience. (4) Self confidence, position level and the kind of nursing license were the most explicable variables of professional autonomy in nursing.

The effect of sheltered workshop activities on the social living activity of the mentally ill was studied in order to evaluate the role and level of function of workshop activities as a self support and employment system for clients, and to determine the future tasks of the workshop and rehabilitative services in the community. The following results were observed: 1) Clients' social living ability appears to be poor, especially in questions related to personal relationships and time distribution, where less than 50% of the clients answered "Possible without assistance". This appears to be characteristics of the living behaviors of mentally ill individuals. 2) Most of the families of the clients evaluated the sheltered workshop activities positively in terms of increasing the clients' social living ability. 3) A survey of families showed that by utilizing the workshop much progress has been made toward improving those living behaviors which are easily made into habits and lifestyle pattern. On the other hand, personal relationships and living behaviors which require coping flexibility, are much more refactory. Based on those results, the future task of sheltered workshops and the supportive role of the public health center need to be examined further.

The purpose of this study was to investigate preschool and grade-school children's effort judgments of fictional figures in children's story under two conditions. In one condition, the information of performance outcomes of fictional figures was given. And in the other condition, the information of performance outcomes plus ability of fictional figures was given. In the outcome information condition, younger children's (preschool and second-grade children) effort judgments were the same as elder children's (fourth- and sixth-grade children) ones. Both younger and elder children judged the effort in success to be higher than that in failure. In the outcome plus ability information condition, however, younger children's effort judgments differed from elder children's ones. Elder children judged the high-ability figure's effort to be lower than the low-ability figure's one, while younger children's effort judgments of the high-ability and the low-ability figures were the same.

The purpose of this study was to examine the effect of the goal attainment difficulty upon interpersonal attraction for the partner. Eighty female undergraduates participated the experiment. They were given tasks with one of four different goal attainment level (very easy, easy, difficult, and very difficult). Each subject solved it with partners of one of three ability levels (superior, similar, inferior to the subject). After the completion of the task, all subjects were requested to evaluate the three partners' instrumental and emotional attractiveness. The main results were as follows: (1) The subjects evaluated the more capable partner as more attractive on the instrumental attraction dimension. (2) The subjects in easy and difficult goal attainment conditions evaluated the superior partner as most attractive on the emotional attraction dimension. While the subjects in very easy and very difficult goal conditions evaluated the similar partner as most attractive on that dimension. These results were discussed in terms of the relationship between the reward value of interaction partner and the task environment.